Document Detail

Long-term treatment of acromegalic patients resistant to somatostatin analogues with the GH receptor antagonist pegvisomant: its efficacy in relation to gender and previous radiotherapy.
MedLine Citation:
PMID:  19147599     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Pegvisomant is an effective treatment for somatostatin analogue-resistant acromegaly, but the determinants defining the response to this treatment are largely unknown. OBJECTIVE: To investigate the efficacy of pegvisomant treatment in resistant acromegalic patients (e.g. serum IGF1 at least 1.25 x upper normal limit) in a clinical setting and the factors conditioning this response. DESIGN AND SETTING: A retrospective cross-sectional study performed in six Spanish University hospitals from 2004 to 2007. Patients Forty-four acromegalic patients (61.4% female, mean age: 49+/-14), 95% of whom had undergone pituitary surgery and 61% having received pituitary radiotherapy. The mean follow-up was 22.7+/-11.2 months. Main outcome measures IGF1 levels reflected treatment efficacy, and the influence of gender, age, weight, previous radiotherapy and duration of treatment was assessed. RESULTS: IGF1 normalisation was achieved in 84% of the patients. Male gender (P<0.05), previous irradiation (P<0.05) and the treatment duration (r=0.364, P<0.02) were associated with a better response to pegvisomant therapy. There was a significant decrease in HbA1c (P<0.001) and in the mean insulin dose (P<0.01) in acromegalic diabetic patients. Although 25% of patients experienced mild adverse events, pegvisomant was only withdrawn in four patients due to side effects (two cases of tumour growth, one liver dysfunction and one headache). CONCLUSIONS: Long-term pegvisomant is a very effective therapy in resistant acromegaly. Male gender and prior radiotherapy influence the therapeutic response rate.
Mónica Marazuela; Tomás Lucas; Cristina Alvarez-Escolá; Manel Puig-Domingo; Nuria Garcia de la Torre; Paz de Miguel-Novoa; Alejandra Duran-Hervada; Rafael Manzanares; Manuel Luque-Ramírez; Irene Halperin; Felipe F Casanueva; Ignacio Bernabeu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-01-15
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  160     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  535-42     Citation Subset:  IM    
Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Spain.
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MeSH Terms
Acromegaly / drug therapy*,  radiotherapy*
Diabetes Complications / drug therapy
Diabetes Mellitus / drug therapy,  metabolism
Drug Resistance
Human Growth Hormone / adverse effects,  analogs & derivatives*,  therapeutic use
Insulin-Like Growth Factor I / metabolism
Long-Term Care
Middle Aged
Receptors, Somatotropin / antagonists & inhibitors*
Recombinant Proteins / therapeutic use
Sex Characteristics
Somatostatin / analogs & derivatives*,  therapeutic use*
Young Adult
Reg. No./Substance:
0/Receptors, Somatotropin; 0/Recombinant Proteins; 0/pegvisomant; 12629-01-5/Human Growth Hormone; 51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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